Getting good sleep


Anyone who has suffered even an occasional bout of insomnia can tell you it’s no picnic. According to the National Institutes of Health, 25 percent of Americans report at least occasional insomnia, which includes difficulty in falling asleep or staying asleep or waking up too early or all three, while 10 percent are chronic insomniacs.

How much sleep one needs varies. Most adults do best with eight hours, but some claim to function well with only four, while others need at least 10. After age 60, six hours may do, although nearly half of those over 60 report some degree of insomnia.

The only way to determine your optimum sleep time is how you feel when you awaken. Shallow, non-REM (rapid eye movement) sleep is typical for older people. If this stage is uninterrupted, slow wave sleep (SWS) cycles, the most restorative stages, will follow. SWS cycles are more difficult to achieve and maintain, however. It takes time for the body to progress from non-REM sleep to SWS, and any disruption, even if the sleeper doesn’t actually wake up, shifts the body back to lighter sleep.

SWS cycles are necessary not only for daytime alertness, but also for the regulation of hormones. One of the functions that occurs during SWS is glucose homeostasis, the appropriate balancing of blood sugar levels. Some researchers now believe that a lack of SWS could be a contributing factor in the development of type 2 diabetes, which is on the rise for older adults. Additionally, lack of SWS sleep often results in weight gain since another of these functions is the regulation of appetite-controlling hormones.


Not a small thing


Getting good, recuperative sleep, like so many things, is harder for older people. Generally, their sleep is not as deep as when they were younger. But a lack of good sleep is no small thing. Insomnia has serious side effects for seniors. It can slow response times and affect attention, leading to falls and other accidents. A chronic lack of sleep can lead to symptoms that mimic Alzheimer’s disease. Depression is another potential problem. Since those with depression tend to stay indoors and sleep during the daytime, restful nighttime sleep is that much harder to achieve.

Older people are more likely to wake up one or more times a night to urinate, further disrupting sleep cycles. Also, researchers at the University of Toronto say that sleep apnea—which causes sleepers to actually stop breathing repeatedly during the night, sometimes for a minute or longer—is more common in post-menopausal women due to decreased hormone levels.


What to do


In the elderly, insomnia can be a symptom of another condition, one that is treatable. Certainly if frequent urination, sleep apnea, pain, depression or other problems are behind your sleeping difficulties, you should talk to your doctor. Often, though, there are simple steps you can take that will help you get to sleep and stay asleep. Kathy Shortelle, R.N., Salisbury Visiting Nurse Association’s clinical supervisor, says that the atmosphere of the bedroom should be conducive to sleep. "First, make sure that your bedroom is a pleasant, quiet, calming place, kept at a temperature that is comfortable for you, and be sure there’s adequate ventilation." Maybe a new mattress or new pillows are in order. If neighborhood noises disturb you, you might try a white noise machine that masks annoying sounds with soothing ones.

Get up at the same time every day and try to avoid daytime naps. "If you have to rest during the day," Shortelle said, "set aside a designated time for it, no longer than an hour. Have a regular bedtime — but don’t go to bed if you’re not sleepy."

A mug of warm milk works for some, and a light snack may help. "Eat a lighter evening meal," SVNA nurse Debbie Welch, R.N., recommended. "Avoid feeling heavy or too full and don’t eat anything that is likely to upset your stomach."

Take the television and computer out of the bedroom and use the bed only for sleeping. Get regular exercise, but do it early in the day and, very importantly, get outside in the sunshine. The Journal of Sleep Research reports that short daily exposure to sunlight is exactly what the elderly need to help them feel better, stay active and sleep well.

Avoid caffeine for at least eight hours before bedtime, and give up smoking. Don’t drink alcohol. And, Shortelle said, "try to avoid thinking about stressful or upsetting things. Don’t burden yourself late in the day."


Last resort


Medications, both prescription and over the counter, are available and can be effective, but should be used as a last resort. Try first to establish a bedtime ritual—a warm bath, reading, or listening to music—that will signal to your brain and body that this is the time for rest. Pleasant dreams.

 


Salisbury Visiting Nurse Association, founded in 1904, offers home nursing and hospice care to residents throughout the Northwest Corner. Writer Cyd Emmons is a consultant to SVNA and other area firms.

 

 

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